炎症介质水平升高与重症 COVID-19 患者的临床结局和疾病迁延有关。
Increased inflammatory mediators levels are associated with clinical outcomes and prolonged illness in severe COVID-19 patients.
机构信息
Department of Allergy, Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Yulin 719000, Shaanxi province, PR China; Department of Respiratory and Critical Care Medicine, Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Yulin 719000, Shaanxi province, PR China.
Department of Allergy, Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Yulin 719000, Shaanxi province, PR China; Department of Respiratory and Critical Care Medicine, Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Yulin 719000, Shaanxi province, PR China.
出版信息
Int Immunopharmacol. 2023 Oct;123:110762. doi: 10.1016/j.intimp.2023.110762. Epub 2023 Aug 8.
OBJECTIVE
The purpose of this study was to identify potential predictors of clinical outcome in severe COVID-19 patients and to investigate the relationship between immunological parameters and duration of illness.
METHODS
This single-center study retrospectively recruited 73 patients with severe or critical COVID-19. Immunological indicators include white blood cell count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio, and circulating inflammatory mediators were observed for their association with disease severity, mortality and duration of illness of COVID-19.
RESULTS
Serum inflammatory mediators levels of C-reactive protein (P = 0.015), interleukin 6 (IL-6) (P < 0.001), CX3CL1 (P < 0.001), D-dimer (P < 0.001) and procalcitonin (PCT) (P < 0.001) were increased in critical illness patients compared to those severe COVID-19 patients. CX3CL1 has the highest C-index (0.75) to predict in-hospital mortality in patients with COVID-19. Furthermore, this study shows for the first time that the duration of illness in severe COVID-19 patients is associated with serum levels of CX3CL1 (P = 0.037) and D-dimer (P = 0.014).
CONCLUSION
CX3CL1, D-dimer, PCT, and IL-6 could effectively predict mortality in severe COVID-19 patients. In addition, only the circulating levels of CX3CL1 and D-dimer were significantly associated with duration of illness.
目的
本研究旨在确定严重 COVID-19 患者临床结局的潜在预测因素，并探讨免疫参数与疾病持续时间的关系。
方法
本单中心研究回顾性招募了 73 例严重或危重新冠肺炎患者。观察了白细胞计数、中性粒细胞计数、淋巴细胞计数、中性粒细胞与淋巴细胞比值和循环炎症介质等免疫指标与疾病严重程度、死亡率和 COVID-19 持续时间的关系。
结果
与严重 COVID-19 患者相比，危重症患者的血清炎症介质 C 反应蛋白（P=0.015）、白细胞介素 6（IL-6）（P<0.001）、CX3CL1（P<0.001）、D-二聚体（P<0.001）和降钙素原（PCT）（P<0.001）水平升高。CX3CL1 对 COVID-19 患者住院死亡率的预测具有最高的 C 指数（0.75）。此外，本研究首次表明，严重 COVID-19 患者的疾病持续时间与血清 CX3CL1（P=0.037）和 D-二聚体（P=0.014）水平相关。
结论
CX3CL1、D-二聚体、PCT 和 IL-6 可有效预测严重 COVID-19 患者的死亡率。此外，只有循环 CX3CL1 和 D-二聚体水平与疾病持续时间显著相关。
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